Failure Modes of Total Wrist Arthroplasty: Cross-Sectional Analysis of FDA MAUDE Adverse Event Reports (2015-2025)

This is a cross-sectional review of the FDA MAUDE database looking at adverse event reports for total wrist arthroplasty (TWA) from 2015-2025. Among 313 classifiable reports, aseptic loosening/component migration was the most common failure mode (36.7%), followed by dislocation/instability (18.2%) and infection (13.1%); Stryker and Zimmer Biomet accounted for the vast majority (81.6%) of manufacturer-attributed reports. Because MAUDE lacks denominator data, the authors could only describe patterns of reported complications, not true incidence or comparative failure rates.

AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing

Why it mattersFor hand surgeons counseling patients about TWA durability, this catalogs the real-world complication landscape (loosening, instability, infection) that persists despite implant design advances, reinforcing that TWA should be reserved for carefully selected, lower-demand patients.

Presenting this at rounds? Start here

• ?Given that loosening and instability remain the dominant failure modes across implant generations and manufacturers, how should patient selection criteria for TWA be refined beyond simply 'low-demand' status?
• ?When TWA fails due to loosening or infection, how should surgeons counsel patients preoperatively about the tradeoffs between salvage arthrodesis (loss of motion) versus revision arthroplasty?